Provider Demographics
NPI:1053017061
Name:EICHELBERGER, GABRIELLE (LCSW)
Entity type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:
Last Name:EICHELBERGER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 CAROLINA AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIXVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19460-2471
Mailing Address - Country:US
Mailing Address - Phone:484-553-3698
Mailing Address - Fax:
Practice Address - Street 1:204 CAROLINA AVE
Practice Address - Street 2:
Practice Address - City:PHOENIXVILLE
Practice Address - State:PA
Practice Address - Zip Code:19460-2471
Practice Address - Country:US
Practice Address - Phone:484-553-3698
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-01
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0221191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical